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First published on November 30, 2007, doi:10.1177/0363546507312167
This version was published on January 1, 2008
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Right arrow Achilles tendon
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The American Journal of Sports Medicine 36:104-109 (2008)
© 2008 American Orthopaedic Society for Sports Medicine

Surgical Treatment of Acute Versus Chronic Complete Proximal Hamstring Ruptures

Results of a New Allograft Technique for Chronic Reconstructions

Greg J. Folsom, MD and Christopher M. Larson, MD*

From the Minnesota Sports Medicine Orthopaedic Sports Medicine Fellowship Program and Twin Cities Orthopaedics, Eden Prairie, Minnesota

* Address correspondence to Christopher M. Larson, MD, Minnesota Sports Medicine, Twin Cities Orthopaedics, 775 Prairie Center Dr, Suite 250, Eden Prairie, MN 55344 (e-mail: clars{at}med.unc.edu).

Background: Acute surgical repair of proximal hamstring ruptures has been shown to result in a high return to preinjury activity level.

Hypothesis: Achilles allograft reconstruction of chronic complete proximal hamstring ruptures results in improved function and strength that approaches that of acute surgical repairs.

Study Design: Cohort study; Level of evidence, 2.

Methods: Between 2002 and 2005, 26 patients underwent surgical treatment for complete proximal hamstring ruptures. Twenty-one were acute primary repairs. Five chronic ruptures were treated with Achilles allograft reconstruction with (n = 2) or without (n = 2) interference screw fixation or mobilization and primary repair (n = 1). Isokinetic strength testing was conducted postoperatively in 11 acute and 3 chronic cases, and a functional questionnaire was given at most recent follow-up.

Results: Subjective results for all patients at a mean follow-up of 20 months revealed good leg control in 96%, no pain in 80%, and return to sporting activities in 76%. Ninety-six percent of patients said they would have the procedure done again. With the isokinetic testing available at most recent follow-up, there was no significant difference in the mean hamstring strength deficits for the acute versus chronic groups tested at 60 deg/s (8% vs 21%, P =.295) and 180 deg/s (12% vs 2%, P = .294). Overall, there were 3 major adverse events and 5 patients with superficial wound drainage treated with antibiotics.

Conclusion: Surgical treatment of acute and chronic complete proximal hamstring ruptures can result in a high return to full activity. Reconstruction of chronic ruptures with Achilles allograft appears to restore function and strength comparable to acute repairs.

Key Words: hamstring • tendon rupture • tendon repair • allograft reconstruction






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